__________________________________________________________________________________________________ABSTRACT
Meningitis is the most serious of the frequent acute bacterial infections in children.
In the last few years, the introduction of new vaccines and the appearance of resistance to antibiotics could be modifying the etiologic of the disease and treatment guidelines.
The objective of our study was to analyse epidemiologist, microbiological and clinical characteristics, of meningitis diagnosed in the Paediatric department in the Hospital Clínico Universitario in Valencia in the last 15 years (1989-2004).
The training group consisted of 489 healthy children, from 1 month old to 16 years old. The patients were classified into groups according to etiologic: Neisseria meningitidis, Haemophilus influenzae (Hib), Streptococcus pneumoniae, other bacteria; bacterial meningitis without isolation of the micro-organism (BMWI); benign linfocitic meningitis (BLM); tuberculous meningitis (TM). Clinical variables and results of citoquímics and microbiological analyses of cerebrospinal fluid (CSF), blood culture and detection of virus in lees were studied.
Results and conclusions:
1. Of the total cases, 47% corresponded to BLM; 29% were BMWI; meningococo; 3,2% by neumococo and 2,8% produced 16,3% by Hib. TM there were 2 cases.
2. Meningococo displayed an increase of incidence in 1997, due to serogrupo C. After the introduction in the vacunal calendar of the conjugated vaccine for serogroup C; we observed a progressive reduction of meningitis by this micro-organism.
3. Hib has practically disappeared after the introduction of the conjugated vaccine in 1996 in the calendar.
4. BLM appeared in epidemic buds. The most frequent etiologic was enterovirus, mainly echovirus 6, 11 and 30.
5. The boy/girl proportion was 2/1.
6. We observed, from 1997, strains of meningococo with diminished sensitivity to penicillin (with 2 resistant cases); the resistance of Hib to ampicilina was 66%, and of neumococo to penicillin 38,4%.
7. The most frequent complications were shock and CID. By micro-organisms, those that caused most complications and sequels were Hib and neumococo. The most frequent sequels were hipoacusia and hidrocefalia.